HomeMy WebLinkAbout1999-011774 - pool PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 - €'; `��;
Crystal Bay, Minnesota 55323 Permit Number: ,=:,`� .��J=�..''`�����
(612) 473-7357 Date Issued: ;_ _ _. -, ..
S,r'i J___. . _. ,
SITE ADDRESS:
s=w�-"�:.' _:-�tf�•.�`'�'`!��: f`i;
;`s - � : — - '•�r j:
DESCRIPTION:
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_�Rs;, �}�?`s?'��,� '+.�_=_?"=. 4 'r�-°:�} ;=`i�is_ii._
_, _.:i�'ytv: _.iiEi•�= _.�»r-i ;',j: 3:��;;_._`;� _ �;..St• . .
REMARKS:
_._.. `;'i=�.. . s .._ . _.''_ 's ! . .._ _ ..._!7 . %_'.� �!.____ � i•:._ _:���_ t.�_ . , . ._. .
FEE SUMMARY:
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_...____ ..:...x..t
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CONTRACTOR: -- . - , _ _ _ _... , _ -� �- . ___ OWNER:
.,�._ , . ,.
. E:`f {-E_I E_f�_:_� _;•,�',� -t __.......`_,.`� �';,?-:y: _.y=-�'.-; !._�_�`'`.�'.t'-����I_.
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APPLICANT/P RMI E IG TURE ISSUED BY:SIGNATURE �(�
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Total Fee: $ �9,,7• d'� Date Received: '�--��:-•-- �� %
Entered By: ,�('l�, Permit#: �/r7`7�
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNE OR CONTRACTOR
/ �/ , � -
JOB SITE ADDRESS: � C- Yc �� /�- � ZIP:
����o ��
NAME OF OWNER: ,�D���/��� DGlJ`� NG S PHONE: (home)
� �,�/ (work)
MAILING ADDRESS:�0 ,�� Lf`7"f i E'� C� CITY: ����c� /�IP:
�
CONTRACTOR: � f�C .�� �PHONE:��o� �,3 3 -��s�
CONTACT PERSON: / L-- MOBILE/PAGER:
MAILING ADDRESS: �D �"" �- L t�,Q CITY: �l �J' ZIP: �S—��/�
STATE LICENSE: #
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�������j�������i�//�.��^�
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
�q �
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ �/�l/��
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be in accordance with the ap roved plan.
_ ;
APPLICANT'S SIGNATURE: ATE: �� �� ��
NOTE! Parade o,�Homes events require separate permit appr by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
I . ,
Sec.13.04 RIGHTS OF SIJBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be atored shall be as set forth in this section.
Subd.2. Information required to be given indivldual. An i�ividual asiad to supPly private or confidendal data conceming himself
shall be informed of: (a)the purpose and i�ended use of the requested data within the collecdng state age�y,political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data;(c)any known consequeace arising from his supplying or
refusing to supply private or confidential data;azd(d)the identiry of otl�r persons or entities authorized by state or federal taw to receive the data.
11us requirement shall not apply when an individual is asked to supply invesdgative data,pursuant to section 13.82, subdivision,5, to a law
enforcement officer.
The co R+issio�r of reve�e m�v nlacp the notice reauired under this subdivision in the individual income taz or nrocertv taz refund
inc�ctions instPad of on tho�fornL.
Subd.3. Acces.c to data by individual. Upon request to a responsible authoriry,an i�ividual shall be informed whether he is the
subject of stored data on individuals,and whether it is classified as public,private or confidential. Upon his further request,an individual who
is the subject of stored private or pubiic data oa individuals shall be shown the data without azry charge to lvm a�,if he desires,shall be informed
of the content and meaning of that data. After an individual has been shown the private data aiul informed of its meaning,the data need not be
disclosed oo him for six months thereafter unless a dispute or ac6on puisuant to this section is pending or additional data on the individual has been
collected or creaud. The responsible authority shall provide copies of the privaoe or public data upon request by the individual subject of the data.
The responsible authority may require the requesting person to pay the actual costs of maldng,certifying,and compiling the copies.
The responsible authority shall comply immediately,if possible,with any request made pursuant co this subdivision,or within five days
of the date of the request,excluding Saturdays,Sundays and legal holidays,if immediate complia�e is not possible. If he cannot comply with
the request within that time,he shall so inform the inciividual,and may have an addiaonal five days within wtuch to comply with the request,
ezcluding Saturdays,Sundays and legal holidays.
S�bd.4. Procedure whw data is not accurate or complete. An individual way contest the accuracy or completeness of public or
private data conceming himself. To exercise this right,an ndividual shall notify in writing the responsible authority describing the nature of the
disagree��. The responsible authority shall within 30 days either. (a)wrrect the data fa�nd to be inaccurate or incomplete and attempt w�rify
past recipierns of inaccuiate or incoa►plete data,i�luding recipients named by the individual;or(b)notify ihe individual that he believes the data
to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is i�luded with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions of the admiaistra6ve prceedure act relating
to contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your
. request for a permit or license from the�iry of Orono or any of its departments may require you to furnish certain
private or confidential information.
You aze notified that: �
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6. Your full name is required to process this application or permit.
/�� �/��� Z '~ ��r/�i��-
F � � _ � Mi � L � ��
Add s s-��y �� .�a�
Ciry State Zip Phone
I understand my ri as stated above.
s' aue
6
CHECK OFF LIST FOR ISSUANCE OF PERMITS .
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: i�,3� CrA rcE�c I�cw T�2/!�1 c.� �
PID:
DESCRIPTION OF WORK: (�s�� --
ZONING REVIEW BY: DATE APPROVED: �-� 9
BUILDING REV�W BY: DATE APPROVED: . f� -I 4q-5 g
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes c/ No
PLAN REVIEW Yes ✓ No SEWER COrfN�CITON
STATE SURCHARGE Yes �/ No WATER CONNECTTON
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTTON
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: (-R--►A
Fire Department: �,c�N�i L4�C.�.' Post Office: �,Onf School District: ��LoNa
Lot Area: Sq.ft. o Acres -'—" Width — Depth —
Survey Submitted: Yes D< No Date of Survey: �d�13'4�(
Proposed Setbacks:
Front(Lake): �� Right Side: /�(��
Reaz(Street): y 5 Left Side: y`'�
Adjacent Structures: 1 D' Wetland: N ��
Building Height: Def. Hgt. �1/ //-►- Peak Hgt.
Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
N.�' � Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hardcover Variance Required: Yes No Date of Council Approval:
REMARKS(in house):
7
BUII.DING REVIEW CHECB LIS� � � �
UBC: — CONSTRUCTION TYPE: '
Sq Footage $Per Sq Ftg
BasemenT- • x =
lst Floor a = �
2nd Floor x =
Gazage x =
a =
TOTAL
Estimated Construction Value: $ 1��(��O � I
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hazdcover Removal Mechanical.; Water Connection
_�[ Footing Septic Sewer Connection
�Framing Fireplace Lawn Irrigation . i
Insulation (Masonry) Other
Wall Boazd (Mfg.) Well(State Permit)
_�Final Grading/Filling �Electrical(State Permit)
Other I
REMARKS(IN HOUSE): � � �
--- ------------------------------------------------------------------
�
REVIEW BY OTHERS: DATE•
Access: Existing New . ��,
Access Approval: Date By:
---- ------ ---------------------------------------------------________----------------- �
REI�ZARI�S (TO BE NOTED ON PERMII�: �
I�
8
lltV tIVV/I.HKL�HKtLLt r dx • '�41-JU�II rtu� 1� :J� 11 •l�+ r V1
FRANK R. CARDAREILE Land surveyor, �nc. Land Surveyor
(61?� `;:�1-3031 6440 Flying Cloud Drive Eden Prairie, MN 55344
r • �
�L�r�t�t�a�t� �� �ur��� .
Survey For Lorr ne Owin Book Page�File �"�/9
1830 I,�keviaw Terrace
Orono, MN pPP
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f . ^�� C1TY OF ORON
'' � BUfLDING �RMIT LAN REVI W
��� INSPEJ-IOfR
DATE �'�Sa��19 PERMIT NO.
' I ❑ �.F'P�?OVED A.S SUE;�,,1iTTED
�`���. �t;?�^�^,�'c��V��'IT�1 CORRECTiONS AS �OTcp
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❑ fv�"?'?"A.y'�i�`ti�;=D•--CGRi��vT&RES '3!�1iT
T��:::=�CCC'll'1�rCa are ior your infurmafion.All wcrk.hall be done �
in �uL' ccm��:`i:rce with all sppl',caLia buildirg and oning code�
c,:r,-,,;;n�s inc!udiny items nu!spoc�f!caliy noted i this reviem
$Ca ld� 1"=4�� � '�/ , iy'+F-};�{=iA�SET ON SITE AT Ar 1`IM�$
J- -� �9..� �#�'.r,�F� ' �'"`t�' �+)n�
� Denotes Iron Mon. Found . ���1 -�v t
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1 Mr�y�rMp/rt MY li�rw�w�w�t r�nlaNn d�wrv�r d M M�MAw d j+� C�C
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- rank R. Cuda�elle
5tato Rs�. No. 8608
SEP-2�-1995 12�30 E129332259 P.02
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Survey For,_Lar_r_�i o+�+ir,ds Book Pege File�
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Stst• �teg. No. ��46
TOTAL P.�2
�r�� � v� v��vnv � vl�.��I1VIV VV/ IV/ // VV•VL �' .VL/VL 1\V. IJV
HARDCOVER CALCULATION WORKSHF.ET
� .e,. 6E'TBACK ZONB: {C1RCL�ONE) 0-75' 7S-2S0' I�p.spp' �1�'
A. Haue _.�._. x �.3 • Z -1L"'�
�L�j� wid�h —' � S.F.
...�.�..___ x .�;�1 = �Y��s.F.
----•^"---!�—y x ��._._..._ s "" -- 5.F.
B. Oarege �� ...�_� x �-p�.�P_.._� " .�.�G.��.,o��S.F.
C. 1Mvewsy - !�� x _-.---�.�J�.
� ..�1Y S.F.
-----�� �T x �� ..__ � . S.T.��� /
X / � Qf'C�
D. Sielewa!!c _,,,_ L� y .� x L�,.S—
—�..__...._—. x _-...��.� ` _.,,,Ll,e.t ____S.F.
E. P�do/Ueck _� x
_'.�..------- " S.F.
-..� x � S.F.
F. I.�ndscape x
Uncbrlain _ ^" x , �-�--- �` S.F.
Or Fabric x . — s � � _S.F.
� (3. Othec �,�.,_ x ,�, � S.F.
TOTAL HARDCOVER JN ZONE . • ��`,�'.�/�
1'OTAI.PROP�RTY AREA!N ZQNE S.F. A
A 3 Q . `/c.� ._S.F. B
�- � a Y-`��..— x �oo . , �
A. Houae ., ,s� _ x �3• 3 ' —// /v��
!''"�tb Width •• S.F.
�� x ��� � �a-S.F.
— --_--_.— x ,._ ».._ _ g _,__:S.F.
B. �ero�e _ .3t�.� _ x a� • �
` ---2��S.F.
c. ����tw,y l2 x �y _
- x � 1_._.__. - _%�o�S.F.
D. Sidevrslk y � � ? �
_ x .�r ._. " ------f�2
x / _,_,_,S.F.
----`�-- � ----��' S.F.
�. Patio/Ucck �y �� x �� '��
--..�..__
` _.�U..���S.F.
' X — ` _ S.F.
F. I.and;cape
Underlpin _ x ` S.F.
By Plastic � � x '" S.F.
Or Fabric "-- -----
� S.F.
G. Ocher f70"DL!1L_ _,.. x ��i Q� �7ti�
)� .��L_..,_S.F.
TOTAL NARI7COVER 1N ZONE - �D •��S.F. A
7'OTAL PROPER'fY AREA IN TANF
.1�!LSC(�.,_S.F. B
13 `�• �� �o
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l�F HOUSE HEATING TEST RECORD
�'' � �� APT. FLOOR CITY SUBURB
ADDRESS .�,. �GZ
OCCUPANT OWNER
HEAT LO55 DATE HTG. INST.
SOLD BY INSTALLED BY
Electrical Work By Gas Line By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT HTR. OTHER
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER
Model ;...k ` —— Model
$e►ial �/�T�� Max. BTU Rating __
INPUT MAKE OF FURNACE
Model ^ „`"
CONTROLS
THERMOSTAT Heat Plug Vent Size -
yo�Ve � 'i� KIND OF LINER =��' SIZE_.�_NONE
Limit Draft Hood Regularor _ � -
Limit SeHing Filters Size ' Number
Fan Setting Chimney Location Inside �-- Outside
Pilot Type �'i'' Chimney Construction �.;%`
Pilot Make �
Pilot Model :{�� Smoke Bomb Wiring `
Pilot Timing Draft Test Tag �"�
L.W. Cut Off ff' ' - Door Prossure � Lighting Inst. �''�
Prossure Percent CO2 Date Tested �
Input CFH Percent 02 Company Testing �
Stack Temp. Percent CO Name of Tester
Form 235
DAT TIME
CITY OF ORONO CALLED IN 3� ��
INSPECTION NOTICE SCHEDULED -���� I 1 • �v' C�
PERMIT NO. alll`1� COMPLETED ��- 3 5^
ADDRESS_ � g�� '�-�Ui�e:W -T�,►'✓a��e-
OWNER CONTR. C�f'G►'Yt �oo�S
TELEPHONE N0. �3� ^�'�-��
� DESCRIPTION
01 FOOTI 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
Q
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR O MEET YOU:_Y S_NO
D COMMENTS:`� �'�I �S �E'�� �'��C�O�
y ,y G�`Vl C rv►.�{� `j r �!� ����_
o F� v �� r 1,.�S�" 5 i �
'� cLh ��— �5 c�r
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° 2- //� �t� C�c...i ti► ,/'�r�5 ��'�� � _J
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� ���- �,�,�-� D�'
W
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W
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d ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLETE
W
� RRECT WORK&PROCEED C ISSUE CERTIFICATE OF OCCUPANCY
W
❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONW�THIN HOURS. ❑ PHOTOTAKEN
INSPECTOR WILL REfURN
�STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
❑ INSPECTION REQU�RED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73�J7
OwnerlContractor on site:
Inspector,�'/��- /`�-,� �f
White Copyllnspector's File Canary CopylSite Notice
DAT �TIME �
CITY OF ORONO CALLED IN �d
INSPECTION NOTICE SCHEDULED 16'•3C�
PERMIT NO. I ��-7 y COMPLETED � 1�= 3 C>
ADDRESS I g.3U l-.c�t„�,V i e.uJ �e,✓�q,C.�
OWNER CONTR. �5'�'1 �Cc�l�
TELEPHONE NO. � �3""�-a'S.��
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� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
.Q 02 FRAMING 13 MECNANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
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INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑ CITATION ISSUED
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Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContractor on site:
Inspector.i� -�2_�� ��-U/ S
Whiie Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE —7 SCHEDULED �
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TELEPHONE NO. Q�3��� �
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L� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q FI 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 P�UMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Q OWNERICONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
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❑ INSPECTIONREQUIRED.CALLTOARRANGEACCESS.
Call for the next inspection 24 hours in advance.473-7357
OwnerlContractor on site:
Inspector.��t vc �c:<.r��
White Copy/inspector's File Canary Copy/Site Notice